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Going against popular opinion, committee pushes for delisting of cancer drugs
“If we insist on keeping drugs that are not cost effective and keep giving them to our patients, the consequences are billions of rupiahs that could be used for patients’ other needs and drugs."
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Safety, effectiveness and affordability are the three core values of cost-effectiveness in Health Technology Assessment, committee head Sudigdo Sastroasmoro said. (Shutterstock/Kenishirotie)
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or a patient suffering from a chronic illness, an extra day of life may be worth fighting for. But for a state body tasked with assessing the cost effectiveness of a drug, the issue must be examined from a different perspective, Sudigdo Sastroasmoro said in front of a hearing on March 11 with the House Commission IX, which oversees health care and employment.
Sudigdo is the chairman of the Indonesian Health Technology Assessment (HTA) committee. He was present for only on item on the agenda that Monday morning, namely to decide whether two forms of medication for metastatic colorectal cancer — Bevacizumab and Cetuximab — will be removed from the list of drugs covered under the national health insurance (JKN) scheme.
The issue has garnered nationwide attention and received backlash from patients, activists and doctors associations, such as the Indonesia Digestive Surgery Doctors Association (IKABDI), who asked the Healthy Ministry to withdraw a decree issued in February on delisting Bevacizumab and Cetuximab.
At the March 11 hearing, Sudigdo presented his team's research findings, which claimed that although both drugs are effective in treating cancer, they are not cost effective — meaning that the money spent on the drugs does not significantly add quality adjusted life years (QALY) to a patient’s life.
The findings were heavily criticized and debated by doctors and activists present at the hearing. After five hours, the hearing ended with a decision to postpone the decree. Health Minister Nila Moeloek said the ministry would wait for further studies as IKABDI had argued that the drugs still had positive effect on patients.
A month after the hearing, in a special interview with The Jakarta Post, Sudigdo said that although he respected the decision, it was disappointment to his team, who had worked for months to complete its study.
He acknowledged that everywhere in the world, delisting a drug was never a popular option. But in this case, he stood his ground.
